不同浓度对比剂在64层CT下肢动脉成像中的应用比较

摘要

目的 探讨不同浓度对比剂在下肢动脉CTA中的应用价值.方法 将112例患者按照对比剂浓度随机分为4组,分别为对照组(350mgI/ml)、A组(300mgI/ml)、B组(240mgI/ml)及C组(200mgI/ml),每组各28例,各组行下肢动脉CTA检查,采集原始数据后,传至AW4.7工作站进行图像处理及评分并主、客观评价4组患者腹主动脉下段及下肢各段动脉显影情况及图像质量.结果 腹主动脉下段至小腿动脉全景MIP图像质量评分A、B两组与对照组比较分析差异无统计学意义(P>0.05),C组图像质量评分与对照组差异有统计学意义(P<0.05).各段动脉图像质量比较分析 A 组、B 组腹主动脉下段、髂外动脉、股动脉、腘动脉图像质量评分与对照组差异无统计学意义,小腿动脉图像质量评分略低于对照组,但差异无统计学意义(P>0.05);C组腹主动脉至小腿各段动脉图像质量评分与对照组差异有统计学意义(P<0.05).各段动脉图像信号强度(signal intensity,SI)分析比较A组腹主动脉下段至小腿各段动脉图像质量信号强度SI评分与对照组差异无统计学意义;B组腹主动脉下段至腘动脉图像质量信号强度SI评分与对照组差异无统计学意义,小腿动脉SI略低于对照组,但差异无统计学意义(P>0.05);C组腹主动脉下段至小腿各段动脉图像质量信号强度SI与对照组差异有统计学意义(P<0.05).结论 下肢动脉CTA中,240mgI/ml为最佳对比剂造影浓度,既减少碘对比剂用量,降低对比剂不良反应发生的风险,同时满足临床诊断的需求,具有较强的临床应用价值.%Objective To investigate the application value of different concentration contrast agents in CTA of lower extremity artery. Methods 112 patients were randomly divided into 4 groups according to the different contrast concentration,28 cases in each group,including the control group(350mgI/ml),group A(300mgI/ml),group B(240mgI/ml)and C group(200mgI/ml)for the lower extremities artery CTA examination. After collecting the original data,they were passed to the AW4.7 workstation for image processing and scoring,and the development and image quality of the lower abdominal aorta and lower extremity arteries of patients were evaluated subjectively and objectively. Results There was no significant difference in the lower segment of the aorta to the lower leg artery among group A,B and the control group in the MIP image quality score (P>0.05),but the difference between the C group and the control group was statistically significant(P<0.05). The comparison of the image quality of each segment of the artery demonstrated that the image quality scores of the lower abdominal aorta,the external iliac artery,the femoral artery and the popliteal artery in the A group and the B group were not significantly different from those in the control group,and the image quality score of the calf artery was slightly lower than that of the control group,but there was no statistical significance difference(P>0.05). The difference between the C group and the control group was statistically significant in the image quality of the abdominal aorta to the each segments of the artery of the lower leg (P<0.05).The comparison of the signal intensity(SI)analysis of the inferior segment of the abdominal aorta to the lower leg in group A was not significantly different from that of the control group. There was no statistical significance difference between group Band the control group in the score of the image quality signal intensity(SI)of the lower aorta artery and the lower popliteal,though the SI of the calf artery in group B was slightly lower. There was statistical significance difference between the C group and the control group in the image quality signal intensity(SI)of the lower abdominal artery and the segments of the calf artery(P<0.05). Conclusion According to the CTA of lower extremity artery in 112 patients,240mgI/ml is the optimal contrast concentration,which can not only reduce the dosage of Iodine contrast agent,and reduce the risk of adverse drug reaction,but also meet the requirements of clinical diagnosis and have a significant clinical value.